Dr. Komrokji on Risk Stratification of Therapy-Related MDS

Rami S. Komrokji, MD, clinical director, Department of Malignant Hematology, H. Lee Moffitt Cancer Center, discusses a study that examined risk stratification of therapy-related MDS.

Komrokji said for the study, 370 patients with therapy-related MDS were compared to a cohort of patients with de novo MDS. Half of the patients with therapy-related MDS had solid tumors and the majority were treated with chemotherapy for their prior disease. The results showed that most of the clinical models do predict the outcome of these patients.

From this study, researchers found that if you take a patient with de novo MDS and compare them stage-by-stage with therapy-related MDS, patients with therapy-related MDS always do worse, even if the disease is classified as low-risk therapy-related MDS, Komrokji says. However, there is a subset of patients whose survival can be measured in years. These patients could be treated stepwise as opposed to treating them as high-risk, Komrokji says.

The results found that the revised IPSS and the Global MD Anderson Model were the best models to estimate outcome in therapy-related MDS patients. Komrokji says the next step to risk stratifying these patients would be integrating the molecular mutations in patients with therapy-related MDS.

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